Artificial disc
replacement is
useful in
selected cases
only- Fusion of vertebrae: Spinal fusion may also be referred to as “arthrodesis”
(Arthro – joint; desis – fusion). In this type of surgery, the two adjacent
vertebrae are joined together so that no further movement is possible between
them at the facet joints. - Instrumentation: Posterior fusions can be supplemented by specially designed
fixation devices such as wires, cables, screws, rods, and plates. These devices
increase stability and facilitate fusion.
Artificial Discs
Unfortunately, there are a number of drawbacks to undergoing a spinal fusion. First, the
ability of the bone to heal or fuse varies. The average success rate of a lumbar spinal
fusion is approximately 75%-80%. Failure of the fusion to heal may be associated with
continued symptoms. Second, a spinal fusion at one or more levels will cause stiffness
and decreased motion of the spine. Third, having a spinal fusion at one or more levels
will cause the weight of the body and more stress to be transferred to adjacent levels.
The problem with the transferred stress is that it may cause new
problems to develop at the other levels, which may also lead to
additional back surgery.
Instead of fusing the spine after a discectomy, surgeons
nowadays may implant an artificial disc. The advantage is that
an artificial disc enables a patient to retain normal movement after
surgery.
Total disc replacement surgery using artificial discs should not be done for patients with
osteoarthritis of the facet joints, as the surgery will do nothing to decrease the pain
during movement caused by arthritis. Patients suffering from osteoporosis or
spondylolisthesis are not suitable candidates for an artificial disc. Artificial disc
surgery should ONLY be done for those individuals with degenerative disc
disease without arthritis of the facet joints. Even in these cases, to date it
is still an experimental procedure.